Turkiye Klinikleri Journal of Medical Sciences

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Blefarit Etiyolojisinde Demodex folliculorum ve D. brevis'in Önemi Nedir?
What is the Importance of Demodex folliculorum and D. brevis in the Etiology of Blepharitis?
Erkan YULAa, Özlem M. AYCAN KAYAb, Metin ATAMBAYc, Selim DOĞANAYd, Nilgün DALDALc, Esra AYHAN TUZCUe
aTıbbi Mikrobiyoloji AD,
bTıbbi Parazitoloji AD,
eGöz Hastalıkları AD, Mustafa Kemal Üniversitesi Tıp Fakültesi, Hatay,
cTıbbi Parazitoloji AD,
dGöz Hastalıkları AD, İnönü Üniversitesi Tıp Fakültesi, Malatya
Turkiye Klinikleri J Med Sci. 2013;33(2):420-4
doi: 10.5336/medsci.2012-29698
Article Language: TR
Full Text
ÖZET
Amaç: Demodex folliculorum (DF) ve D. brevis\\\'in (DB) sağlıklı kişilerde enfestasyona yol açabileceği ve blefarit gibi bazı göz problemlerinde önemli olabileceği veya bu parazitlerin var olan hastalığı daha ciddi bir hale getirebileceği bildirilmiştir. Bu çalışmada blefaritli olgularda demodex türlerinin hangisinin yoğunluğunun arttığı ve yüz bölgesindeki demodex yoğunluğunda sağlıklı kişilere göre farklılık olup olmadığının belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmada, 96 blefaritli hasta ile 197 sağlıklı kişinin kirpik ve yüzlerinde demodex türlerinin varlığı araştırılmıştır. Standart yüzeyel deri biyopsisi tekniği ve kirpik epilasyonu ile alınan örnekler ışık mikroskobunda incelenmiştir. Bulgular: Blefaritli olguların ortalama yaşı 46,90±16,92 yıl (yaş aralığı 15-89), kontrol grubundakilerin yaşı ise 39,54±17,61 (yaş aralığı 12-84) yıl olarak hesaplanmıştır. Hastaların kirpiklerinde, 78 (%81,25) örnekte DF pozitif, 25 (%26,04) örnekte ise DB pozitif iken, kontrol grubunda DF ve DB pozitifliği sırasıyla 30 (%15,22) ve 7 (%3,55) olarak bulunmuştur. Hastaların kirpiklerinde demodex görülme oranı kontrol grubu ile kıyaslandığında istatistiksel olarak anlamlı derecede yüksek (p<0,001) saptanmıştır. Yüz bölgesinde demodex pozitifliği açısından anlamlı bir fark bulunmamıştır. Yüz bölgesinde demodex pozitif olan hastaların tamamında da aynı zamanda kirpik örneklerinde demodex pozitifliği bulunurken, kontrol grubunda ise 8 (%24,24) kirpik örneğinde demodex saptanmıştır (p<0,001). Sonuç: Çalışmamızın sonuçları Demodex spp\\\'nin yüz bölgesindeki varlığının blefarit patogenezinde önemli olan faktörlerden bir tanesi olabileceğini vurgulamaktadır. Sonuçta, blefarit tedavisinde demodikozis varlığının tabloyu ağırlaştıran bir faktör olarak düşünülmesinin, tedavinin yönlendirilmesi açısından yardımcı olacağını kanaatindeyiz.

Anahtar Kelimeler: Blefarit; ektoparazitik infestasyonlar
ABSTRACT
Objective: It was reported that, Demodex folliculorum (DF) and D. brevis (DB) may cause an infestation in healthy subjects and, may be important for some eye problems such as blepharitis, or these parasites can bring the present disease into a more serious condition. In this study, we aimed to determine which demodex species' density increase in patients with blepharitis and whether the demodex density on face differs from healthy subjects. Material and Methods: In the study, the presence of demodex species was analyzed on eyelashes and faces of 96 patients with blepharitis and 197 healthy subjects. Samples taken through standard superficial skin biopsy technique and eyelash epilation were analyzed with the light microscope. Results: The mean age of the patients with blepharitis was 46.90±16.92 (15-89) years, whereas the mean age of control group was 39.54±17.61 (12-84) years. Among eyelash samples of the patients, 78 (81.25%) samples were found DF positive, whereas 25 (26.04%) of them were found DB positive; on the contrary 30 (15.22%) and 7 (3.55%) of the control group was DF and DB positive, respectively. Among the eyelash samples of the patients, the demodex incidence was statistically significantly higher compared to the control group (p<0.001). There was no significant difference in terms of demodex positivities on face. All patients who were demodex positive on the facial area were also found demodex positive for eyelash samples whereas 8 (24.2%) of eyelash samples were Demodex spp positive in the control group (p<0.001). Conclusion: The results of our study underline that the presence of Demodex spp on facial area may be one the important factors in the pathogenesis of blepharitis. In conclusion, we suggest that taking the demodicosis presence into consideration as a worsening factor may help in the management of blepharitis.

Keywords: Blepharitis; ectoparasitic infestations

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